1. Physiological Changes In Pregnancy DR.FATMA AL-DAMMAS

2. Changes In Pregnancy Pregnancy brings about many physical changes. These changes can be divided into 3 area – Anatomical Physiological Biomechanical.

3. Changes In Pregnancy Pregnancy brings about many physical changes. These changes can be divided into 3 area – Anatomical Physiological Biomechanical.

5. 1. What are physiological changes during labour ?

6. Average maximum physiological changes associated with Pregnancy Parameter Change Neurologic MAC (minimum alveolar concentration )

7. Average maximum physiological changes associated with Pregnancy Parameter Change Neurologic MAC (minimum alveolar concentration ) - 40% 1.(MAC) progressively decreases during pregnancy—at term, by as much as 40%—for all general anesthetic agents 2.MAC returns to normal by The third day after delivery.

11. 2. What are Respiratory physiological changes during labour ?

12. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption Minute ventilation Tidal volume Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )

13. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation Tidal volume Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )

14. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )

15. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )

16. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )

17. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 HCO 3 FRC (functional residual capacity )

18. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 - 15% HCO 3 FRC (functional residual capacity )

19. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 - 15% HCO 3 - 15% FRC (functional residual capacity )

20. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 - 15% HCO 3 - 15% FRC (functional residual capacity ) - 20%

27. Following adequate preoxygenation, the PaO 2 in apnoeic pregnant women falls ~ 80 mmHg/min more than in the nonpregnant state

31. Alteration of Lung Volume in Pregnancy Functional Residual Capacity FVR Residual Volume RV ~ 20% decrease Expiratory Reserve Volume ERV Vital Capacity VR Inspiratory Reserve Volume IRV unchanged Closing Volume CV Total Lung Capacity TLC ~ 5% decrease Inspiratory Capacity IC ~ 5% increase

33. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume Plasma volume Cardiac output Stroke volume Heart rate Peripheral resistance

34. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume Cardiac output Stroke volume Heart rate Peripheral resistance

35. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output Stroke volume Heart rate Peripheral resistance

36. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume Heart rate Peripheral resistance

37. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume + 30% Heart rate Peripheral resistance

38. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume + 30% Heart rate + 15 to 30% Peripheral resistance

39. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume + 30% Heart rate + 15 to 30% Peripheral resistance - 15%

54. Average maximum physiological changes associated with Pregnancy Parameter Change Renal GFR

55. Average maximum physiological changes associated with Pregnancy Parameter Change Renal GFR + 50%

66. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin Platelets Clotting factors

67. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin - 20% Platelets Clotting factors

68. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin - 20% Platelets - 10 to 20% Clotting factors

69. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin - 20% Platelets - 10 to 20% Clotting factors + 50 to 250%

80. Foetal functions Foetus depends on the placenta for 1.Gas exchange – Respiration 2. Nutrition 3. Waste product elimination

89. Stages of Labour

91. Pain pathways during labor

103. “ A Pregnant Lady Is Like A Ticking Bomb That Can Burst Into Fatality Any Moment” Channa A B

104. THANK YOU